Individual
DARRYL ANTHONY JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3100 MILL ST, SUITE #206, RENO, NV 89502-2259
(775) 348-8048
(775) 348-8043
Mailing address
3100 MILL ST, SUITE #206, RENO, NV 89502-2259
(775) 348-8048
(775) 348-8043
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100511515
—
NV
Enumeration date
06/16/2011
Last updated
06/16/2011
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